Lyons seeks control board, major changes for MassHealth

Wednesday

Apr 26, 2017 at 12:36 PMApr 26, 2017 at 1:30 PM

By Andy MetzgerSTATE HOUSE NEWS SERVICE

Most MassHealth enrollees would have to make contributions toward their government coverage and a control board would be installed to rein in spending at the state's Medicaid program, under a budget proposal touted by five Republican House members on Monday.

"It's become an insurance plan for everyone," Rep. James Lyons, R-Andover, said at a press conference on Monday as the House began its annual budget debate. He said, "We want to make sure that the poor and the disabled are protected and not crowded out by the infusion of people onto this plan."

Lyons estimated the new annual fees would bring in $3.5 billion, while cost controls could save $4 billion to $6 billion in the program, which receives substantial federal funding.

Lyons was joined by Reps. Marc Lombardo, of Billerica; Shaunna O'Connell, of Taunton; David DeCoste, of Norwell and Kevin Kuros, of Uxbridge. The lawmakers said taxpayer costs have soared as people opt for free, state coverage instead of enrolling in health plans through employers.

The lawmakers said the system has allowed for people to enroll in government health care even if they could receive coverage through an employer or have substantial assets. Their plan seeks to exclude workers who could take insurance through an employer and would create a work requirement for able-bodied adults receiving state-sponsored health care.

"This is not judgmental whatsoever to anybody who were to elect to get something for free or at greatly reduced cost than what they're currently paying for it. This is not a judgement call for why people made that move," said Kuros. "You shouldn't hate the player. You should hate the game, because the game allows people to do this."

The plan, which Lyons said has been presented to the Baker administration, is contained in amendments 880, 886, 876, and 878 to the $40.3 billion House Ways and Means budget. Lyons said MassHealth savings would be passed along to cities and towns, which rely on the state for major portions of their own budgets.

Gov. Charlie Baker has taken a different tack to dealing with the cost growth of MassHealth, which Lyons said takes up 42 percent of the budget. The Republican governor proposed a $2,000 per employee assessment on businesses with more than 10 employees that don't insure 80 percent of their fulltime staff or don't offer health coverage. The House Committee on Ways and Means gave the Baker administration the go-ahead to pursue that strategy in its budget bill.

The proposal backed by more outspokenly conservative members of the House Republican caucus would establish a sliding payment scale - that averages out to $2,000 - on the majority of MassHealth enrollees who earn more than the federal poverty line.

Lombardo said the Fiscal and Management Control Board at the MBTA has demonstrated how new management can dramatically reduce costs. The plan co-sponsored by Lombardo would cap MassHealth spending at 30 percent of the state budget.

At a press conference held outside the fourth-floor entrance to the State House library, the lawmakers also said elements of their MassHealth plan would likely require waivers from the federal government.

President Donald Trump and the Republican-led Congress failed in an attempt earlier this year to repeal and replace the Affordable Care Act, the Obama era law that supported an expansion of Medicaid eligibility.

Lyons said policymakers in Washington, D.C. want to see proposals from the states, and he said the Baker administration is also looking for ideas.